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Contributors Introduction Acknowledgements Abbreviations 1 The history of children???s perioperative care ??? Jeremy Jolley Why history is important What is perioperative nursing? A brief history of perioperative nursing An overview of the history of surgery The development of perioperative nursing Key discoveries in perioperative care Early beginnings of surgery for children The growth of paediatric surgery Conclusion: perioperative nursing of children References 2 The psychosocial care of children in the perioperative area ??? Linda Shields Children???s perceptions of the operating theatre The effect of hospitalisation on children Models of care The presence of parents Play in the operating theatre suite Emotional, social and spiritual needs of the patient Conclusion References 3 Care of the child in the operating room ??? Linda Shields and Ann Tanner Preparation of children for theatre Admission prior to surgery Observation Weight Surgical history Medical history Medications Body/site preparation Pre–admission clinic Emergency admission Day of surgery admission Reception in the operating suite Registration on entrance to the OR Fasting Other things to check on admission to the OR Safety of children in the operating theatre Specific safety issues for children during induction Post anaesthetic/post operative Standing orders Conclusion References 4 Nursing care and management of children???s perioperative pain ??? Bernie Carter and Denise Jonas Introduction Preparing and teaching children and parents about pain Agency, education and training of health care professionals Assessing children???s pain Core approaches to pain assessment What tools to consider using with particular groups of children Non–pharmacological interventions Overview of pharmacological intervention Routes of administration Other local anaesthetic infusions Discharge home Conclusion References 5 Surgical procedures on children ??? Linda Shields and Ann Tanner Introduction Common surgical procedures performed on children Acknowledgement References 6 Day surgery for children ??? Ann Tanner Day procedure centres Pre–admission preparation Admission to the day procedure centre: preparations for surgery Compartment syndrome Admission to theatre Ward stage recovery: post–operative care Conclusion: support at home References 7 Anaesthesia in children ??? Wendy McAlister Introduction: What is anaesthesia? The anaesthetic nurse Children undergoing anaesthesia Anaesthetic equipment Airways Anaesthesia Analgesia Patient preparation Fasting Premedication Loose teeth and nail polish Hearing aids and glasses Jewellery Preparation prior to patient arrival Patient arrival in theatre Induction Rapid sequence induction Fluids Monitoring Documentation Anaesthetic emergencies Anaphylaxis Suxamethonium apnoea Malignant hyperthermia Emergence Regional anaesthesia References 8 The paediatric post–anaesthetic care unit ??? Eunice Hanisch Introduction In the PPACU The post–operative environment Oxygen delivery Suction Physiological assessment and management of the paediatric post–anaesthesia patient A ??? Airway management and B ??? Breathing Respiratory complications and nursing interventions C ??? Circulation Thermoregulation and temperature abnormalities Post–operative nausea and vomiting Pain management in the PPACU Infection control Fluid and electrolyte balance Wounds and dressings Patient positioning Latex allergy Children with epilepsy Delayed emergence Emergence delirium Discharge of the patient from the PPACU Psychological assessment References 9 Fetal surgery ??? Roy Kimble Introduction History The risks of fetal surgery Fetal conditions amenable to fetal surgery Ex utero intrapartum treatment (EXIT) The future References 10 Perioperative care of children with burns ??? Roy Kimble and Julie Mill Introduction History Epidemiology of burns in children A multidisciplinary service approach Clinical assessment of burn severity A ??? Airway B ??? Breathing C ??? Circulation D ??? Neurological disability E ??? Exposure with environment control Classification of burn depth Determination of burn depth Laser Doppler scanning Electrical burns Chemical burns Calculation of burn surface area Management Burn wound care Preparation for theatre Pain management via acute pain service Post–operative care Physiotherapy Infection control Toxic shock syndrome Tetanus Human immunodeficiency virus (HIV)–positive children Scar management Discharge planning References 11 Paediatric transplantation ??? Rebecca Smith and Susan Tame Introduction Becoming an organ donor Types of donation Role of the transplant co–ordinator Donor care and management Making the donation request Preoperative care of a potential paediatric donor Perioperative care Recipient management and care Cardiothoracic organs Immediate post–operative care Liver Kidneys Small bowel, liver and multivisceral Reducing the risk of rejection of the new organ Longer–term post–operative care The future References Further reading 12 The care of children having endoscopic procedures ??? Janet Roper and Linda Shields Introduction The perioperative nurse???s role Preparing children for endoscopic procedures Perioperative care Service perspectives Equipment for MIS and endoscopy Conclusion References 13 Ethical and legal issues in paediatric perioperative care ??? Linda Shields Patients??? rights Self–determination Privacy Confidentiality Consent Legal perspectives Medical futility Conclusion References Index